Lisa Rosenbaum, M.D.: Transitional Chaos or Enduring Harm? The EHR and the Disruption of Medicine A decade ago, a primary care doctor I undone admired appeared to come facts . His performance had derived not from rushing between patients but from understanding them therefore well that his charting was effortless and fast. But abruptly he became distracted, losing his hold on the details of his patients’ lives. He slumped around, shirt half-untucked, perpetually pulling a yellowed handkerchief from his pocket to clean his perspiring forehead. Everyone worried he was unwell. His problem, however, ended up being the electronic health record . Investigating the root causes, Wachter discovers design flaws, such as for example defaulting to certain devices for medication dosing and alerts rendered meaningless by their sheer number.

If 15 % of strokes happen during sleep, an estimated 58,000 Americans each year come to an emergency space because they woke up with stroke symptoms, the authors report in the journal Neurology. But imagine if some of them had their strokes before they woke up, of many hours earlier instead? That could have produced them eligible for treatment. This becomes an presssing issue, the authors say. Indeed, one-third of the people who experienced wake-up strokes could have received the drugs if period had not been an issue. They didn’t possess any other features that could disqualify them from receiving tPA, such as high blood pressure or a recently available surgery.